Individual
MR. MICHAEL EUGENE TJARKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 544-5311
(262) 544-6820
Mailing address
N15W28300 GOLF RD, PEWAUKEE, WI 53072-4800
(262) 303-5055
(262) 303-5057
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
39946
WI
207XS0117X
Orthopaedic Surgery of the Spine Physician
39946
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639152747
—
WI
Enumeration date
11/22/2005
Last updated
12/27/2019
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